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Streamlined audit and fraud program
In this second of our three-part series on the Center for Medicare and Medicaid Services’ (CMS) audit and fraud programs, the Advocacy Council (AC) focus…
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Confused by the Medicare audit and fraud programs?
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We’ve got your back
Read our comments to CMS about the 2018 Physician Fee Schedule. Can't see the PDF preview? Access it here.
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When natural disasters strike
Between wildfires in the West and hurricanes in the South, it seems hardly a day has gone by over the last few weeks when reports of natural disasters are not …
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Unsure how or if you will avoid the MACRA penalty?
我们现在超过一半through 2017 and the first year of the MACRA Quality Payment Program. Practices must participate in MIPS or Advanced Alterna…
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Tell us how CMS could change E&M Guidelines
The Centers for Medicare & Medicaid Services (CMS) is seeking comments on how to revise the Evaluation and Management (E&M) documentation guidelines to…
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Change is coming to United Health Care
The Advocacy Council has learned that beginning October 1, 2017, United Health Care (UHC) will stop paying for physician visits billed under certain inpatient …
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Where has all the epinephrine gone?
The Advocacy Council (AC) has recently been contacted by several members with complaints of bulk injectable epinephrine costs going up exponentially. Epinephri…
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ACA Repeal and Replace: Now what?
As you know, the Senate has been going through the Budget Reconciliation process with the objective of adopting legislation that would effectively repeal and r…
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What’s all the RUCkus? Why do Medicare payments go up and down?
你们中的很多人可能想知道为什么支付的皮肤testing (CPT Code 95004) is slated to be cut by 21% next year while other allergy codes stay the same (or eve…
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The Advocacy Council responds to CMS request for comments on Reducing the Regulatory Burdens of the Patient Protection and Affordable Care Act
The Department of Health and Human Services (HHS) is actively working to reduce regulatory burdens and improve health insurance options under Title I of the Pa…
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Medicare Proposed 2018 Fee Schedule just released
The long-awaited proposed Medicare fee schedule for 2018 was just released last Thursday and there are several proposals you should know about.Easing of PQRS P…
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House Passes Medical Liability Reform Bill
While much of the national focus on health care reform has been on efforts to repeal and replace the Affordable Care Act, the House of Representatives has take…
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It’s a virtual world
More and more it seems we are living in a virtual world. First, it was virtual games played on your computer. More recently we’ve heard reports abo…
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ACA Repeal and Replace Update: Detailed analysis
Like the American Health Care Act (AHCA), the Senate proposal would provide “refundable” and “advanceable” tax credits for individuals …
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ACA Repeal and Replace Update
Recently, the Senate GOP leadership released a “discussion draft” of legislation to repeal and replace the Patient Protection and Affordable Care A…
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Frustrated with “fail first” MCO policies? The Advocacy Council steps in.
In recent years, managed care organizations (MCO) have increased the use of “fail first” policies, commonly called “step therapy,” as a…
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Update on eClinicalWorks and Meaningful Use incentive payments
Last week we let you know that on May 31, the U.S. Department of Justice announced a massive settlement with eClinicalWorks (eCW), one of the nation’s la…
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eClinicalWork Settles with Department of Justice for $155 million
On May 31, 2017 the U.S. Department of Justice announced a massive settlement with eClinicalWorks (eCW), one of the nation’s largest EHR vendors whose pr…
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National Government Services’ Medical Review of CPT 99214
The Advocacy Council received notice that the National Government Services’ (NGS) Medical Review department will be focusing on CPT 99214 in Connecticut,…